title: The characteristic of heat wave effects on coronary heart disease mortality in Beijing, China: a time series study.
abstract: BACKGROUND
  There is limited evidence for the impacts of heat waves on coronary heart disease (CHD) mortality in Beijing, capital city of China.
  
  
  OBJECTIVE
  We aimed to find a best heat wave definition for CHD mortality; and explore the characteristic of heat wave effects on CHD in Beijing, China.
  
  
  METHODS
  We obtained daily data on weather and CHD mortality in Beijing for years 2000-2011. A quasi-Poisson regression model was used to assess the short-term impact of heat waves on CHD mortality in hot season (May-September), while controlling for relative humidity, day of the week, long-term trend and season. We compared 18 heat wave definitions by combining heat wave thresholds (87.5(th), 90.0(th), 92.5(th), 95(th), 97.5(th), and 99(th) percentile of daily mean temperature) with different duration days (≥ 2 to ≥ 4 days), using Akaike information criterion for quasi-Poisson. We examined whether heat wave effects on CHD mortality were modified by heat wave duration and timing.
  
  
  RESULTS
  Heat wave definition using 97.5(th) percentile of daily mean temperature (30.5 °C) and duration ≥ 2 days produced the best model fit. Based on this heat wave definition, we found that men and elderly were sensitive to the first heat waves of the season, while women and young were sensitive to the second heat waves. In general, the longer duration of heat waves increased the risks of CHD mortality more than shorter duration for elderly. The first two days of heat waves had the highest impact on CHD mortality. Women and elderly were at higher risks than men and young when exposed to heat waves, but the effect differences were not statistically significant.
  
  
  CONCLUSIONS
  Heat waves had significant impact on CHD mortality. This finding may have implications for policy making towards protecting human health from heat waves.
authors.affiliation: Emergency Department of Peking University Third Hospital, Beijing, China.
authors.forename: Zhaoxing
authors.initials: Z
authors.lastname: Tian
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.forename: Jinliang
authors.initials: J
authors.lastname: Zhang
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
mesh_terms: D002681:China / Q000453:epidemiology; D002965:Classification; D003327:Coronary Disease / Q000401:mortality*; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D049674:History, 21st Century; D006801:Humans; D008297:Male; D012044:Regression Analysis; D013696:Temperature; D013997:Time Factors